Changes in the NHS under the "ConDem" governement

What will the change mean for nurses who work within the NHS, and what do our overseas colleagues have to offer to the discussion. I wonder if we are steadily heading our way towards privatisation and this worries me.

There are major changes ahead in the way the NHS in England will be funded

A bill has been published which paves the way for a major shake-up of the health service.GPs are being given much more responsibility for spending the budget in England, hospitals are to be set free from central control and an independent board will oversee services. It has been dubbed one of the most radical plans in the history of the NHS.

According to this article, patients will not see any changes at all, what it will give is General Practitioner the power to buy services for their patients from, this may be an NHS establishment however it could also be within the private sector.

The concerns are that the private sector will undercut the NHS and "cherry pick" patients from the well, young and minimal co-morbidities leaving the NHS to deal with the chronic diseases, co-morbidity patients and generally those with poorer outcomes, these patients will be the ones who require more expensive care therefore costing NHS establishments more to treat them.

For example, this could impact on day surgery services, making them no longer viable for a NHS establishment to run, as the local private hospital is offering the GP deals to do them at a lower cost. NHS services will be cut to cope with the loss of income.

There are also proposals to change the way hospitals work, getting all to self governing foundation status and lifting the cap on the amount of private income they can earn, getting them to compete with private hospitals for work.

I know that a mixture of private and public healthcare works in some countries, but I have to admit that I have a great deal of anxiety about where this government will take our health service.

Get ready: In the future, your hospitals will look like ours (in America). All of the patients with private insurance will go to fancy private hospitals and have unnecessary and expensive procedures done while poor sickly patients will be left to die in squalid decrepit facilities while the general public and politicians blame the patients for their lack of personal responsibility and the hospital for its "inability to attract paying patients." There will be long lists of ways these hospitals can and should observe the stellar example set by wealthier private hospitals and follow suit. Most will ignore the fact that some patients will always be poor and sickly.

As for you, you will have two options: hand out sprites and sugary snacks to overweight diabetics having questionably effective orthopedic surgeries in a private hospital while making an excellent wage with good benefits and abusive physicians or take a job in the "poor hospital" where you bust your rear end to take care of the poor and the sick while received costly benefits and somewhat less attractive wages (and the doctors might actually seem a slight bit more friendly).

Let me know which heartbreak you decide upon...

With affection from America,

Vic, ED RN

Jan 24, '11

Sadly Vic, I think there is a lot of truth to your post.

XB9S,

I read a negative NHS story in the UK papers almost daily. These horror stories of someones 88 year old Gran being "starved and neglected" to death seem to be not only in The Daily Mail, but also The Guardian and The Independent.

What is troubling is even after the Mid Staffordshire Enquiry, these newspaper reports are all about lazy nurses and uncaring staff - never about the true failings of Staffordshire. The main failings seemed to be bad management and a cut to the bone staffing system. The newspapers never reported the true story of the Enquiry.

I believe that the British press has been swaying public opinion around to privatization for years. Now they have a government that will take them there.

Jan 25, '11

I spent quite a while reading the actual report from Staffordshire and it was harrowing. Your right, the newspapers didn't pick up that at the heart of the problem was breakdown in communication and relationships between management, medics and nurses.

I worry that by making the NHS an organisation that has to compete with other NHS and private companies it'll push managers into corners to cut and trim services when, those of us that already work in the NHS understand that most of the services are already cut to the bone.

It's a worrying time and I fear we have until the next election before we will be in a position to do anything about these changes.

Get ready: In the future, your hospitals will look like ours (in America). All of the patients with private insurance will go to fancy private hospitals and have unnecessary and expensive procedures done while poor sickly patients will be left to die in squalid decrepit facilities while the general public and politicians blame the patients for their lack of personal responsibility and the hospital for its "inability to attract paying patients." There will be long lists of ways these hospitals can and should observe the stellar example set by wealthier private hospitals and follow suit. Most will ignore the fact that some patients will always be poor and sickly.

As for you, you will have two options: hand out sprites and sugary snacks to overweight diabetics having questionably effective orthopedic surgeries in a private hospital while making an excellent wage with good benefits and abusive physicians or take a job in the "poor hospital" where you bust your rear end to take care of the poor and the sick while received costly benefits and somewhat less attractive wages (and the doctors might actually seem a slight bit more friendly).

Let me know which heartbreak you decide upon...

With affection from America,

Vic, ED RN

I think I would rather leave the NHS before working in either of these options, but as I am financially dependent on my work I'll go for the second option thanks. I have always and will always be an advocate of healthcare free at the point of care, and although I think we are quite a way off that changing I do think this is possibly where we are heading and it saddens me.